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Gastrointestinal Endoscopy Clinics of... Jan 2017Comprehension of small intestine physiology and function provides a framework for the understanding of several important disease pathways of the gastrointestinal system....
Comprehension of small intestine physiology and function provides a framework for the understanding of several important disease pathways of the gastrointestinal system. This article reviews the development, anatomy and histology of the small bowel in addition to physiology and digestion of key nutrients.
Topics: Humans; Intestine, Small
PubMed: 27908510
DOI: 10.1016/j.giec.2016.08.001 -
World Journal of Gastroenterology Jun 2015Generally, proton-pump inhibitors (PPIs) have great benefit for patients with acid related disease with less frequently occurring side effects. According to a recent... (Review)
Review
Generally, proton-pump inhibitors (PPIs) have great benefit for patients with acid related disease with less frequently occurring side effects. According to a recent report, PPIs provoke dysbiosis of the small intestinal bacterial flora, exacerbating nonsteroidal anti-inflammatory drug-induced small intestinal injury. Several meta-analyses and systematic reviews have reported that patients treated with PPIs, as well as post-gastrectomy patients, have a higher frequency of small intestinal bacterial overgrowth (SIBO) compared to patients who lack the aforementioned conditions. Furthermore, there is insufficient evidence that these conditions induce Clostridium difficile infection. At this time, PPI-induced dysbiosis is considered a type of SIBO. It now seems likely that intestinal bacterial flora influence many diseases, such as inflammatory bowel disease, diabetes mellitus, obesity, non-alcoholic fatty liver disease, and autoimmune diseases. When attempting to control intestinal bacterial flora with probiotics, prebiotics, and fecal microbiota transplantation, etc., the influence of acid suppression therapy, especially PPIs, should not be overlooked.
Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Drug Interactions; Dysbiosis; Humans; Intestine, Small; Proton Pump Inhibitors; Risk Factors
PubMed: 26078557
DOI: 10.3748/wjg.v21.i22.6817 -
Current Opinion in Gastroenterology Mar 2013Recent studies have evaluated intestinal physiology following bowel resection; understanding changes in small bowel physiology after intestinal transplantation has... (Review)
Review
PURPOSE OF REVIEW
Recent studies have evaluated intestinal physiology following bowel resection; understanding changes in small bowel physiology after intestinal transplantation has received less attention. In this review, we will examine recent studies focused on changes in intestinal physiology following resection and intestinal transplantation.
RECENT FINDINGS
Absorption, immunity, and motility are fundamental components of small bowel physiology. Absorption after resection or transplantation is mediated by adaptation and enterocyte function. After resection, adaptation results in increased villus height and crypt depth. Hepatocyte growth factor and epidermal growth factors cause enterocyte hypertrophy and hyperplasia, allowing greater peptide uptake. Little is known about intestinal adaptation after transplant, but enteral autonomy is attainable. Immunity in small bowel after transplantation relies on a balance of innate and adaptive immune responses in the presence of the luminal microbiota. Intraepithelial lymphocytes are decreased following small bowel resection. After small bowel transplant, the number and the ratio of intraepithelial lymphocytes to enterocytes, as well as changes in the microbiota, can be used to identify rejection. After intestinal transplant, immune-mediated dysmotility is common. Perioperative infliximab in addition to tacrolimus may decrease the inflammation that contributes to dysmotility.
SUMMARY
As intestinal transplantation becomes more successful, understanding how absorption, immunity, and motility changes will allow for optimization of bowel function.
Topics: Adaptation, Physiological; Adaptive Immunity; Gastrointestinal Motility; Humans; Immunity, Innate; Intestinal Absorption; Intestine, Small; Malabsorption Syndromes; Postoperative Period; Short Bowel Syndrome
PubMed: 23380574
DOI: 10.1097/MOG.0b013e32835c9c9d -
Clinics in Laboratory Medicine Dec 2013Adenocarcinoma of the small intestine is relatively rare in comparison to colorectal carcinoma. Adenocarcinoma of the small intestine arises through the... (Review)
Review
Adenocarcinoma of the small intestine is relatively rare in comparison to colorectal carcinoma. Adenocarcinoma of the small intestine arises through the adenoma-carcinoma sequence in the colon. However, adenocarcinomas arising in the background of inflammatory bowel disease develop through the dysplasia-carcinoma sequence. Most of the cases occur in the duodenum; however, adenocarcinoma occurring in association with Crohn disease is more common in the ileum.
Topics: Humans; Intestinal Neoplasms; Intestine, Small; Molecular Diagnostic Techniques
PubMed: 24267190
DOI: 10.1016/j.cll.2013.08.007 -
Der Internist Jun 2010
Topics: Diagnostic Imaging; Humans; Intestinal Diseases; Intestine, Small; Radiography
PubMed: 20449559
DOI: 10.1007/s00108-010-2637-y -
Nutrition Reviews Oct 2005Gluconeogenesis is responsible for the maintenance of blood glucose levels as hepatic glycogen stores become depleted. Traditionally, only liver and kidney have been... (Review)
Review
Gluconeogenesis is responsible for the maintenance of blood glucose levels as hepatic glycogen stores become depleted. Traditionally, only liver and kidney have been believed to be capable of gluconeogenesis, but a gluconeogenic capacity for the small intestine has recently been proposed. This possibility is supported by the expression of key gluconeogenic enzymes and radiolabeled tracer experiments, but these data are not unequivocal and alternative roles can explain the presence of gluconeogenic enzymes in this organ.
Topics: Blood Glucose; Gluconeogenesis; Humans; Intestine, Small; Postprandial Period
PubMed: 16295149
DOI: 10.1111/j.1753-4887.2005.tb00114.x -
Prostaglandins & Other Lipid Mediators May 2000Prostaglandins play an important role in modulation of various physiologic processes in the small intestine. In this review, the involvement of prostaglandins in various... (Review)
Review
Prostaglandins play an important role in modulation of various physiologic processes in the small intestine. In this review, the involvement of prostaglandins in various small-intestinal functions including small-intestinal secretion, mucosal protection, epithelial and endothelial barrier function, and motility are discussed.
Topics: Animals; Eicosanoids; Humans; Intestine, Small
PubMed: 10867125
DOI: 10.1016/s0090-6980(00)00068-x -
Annals of Surgery Nov 2004
Topics: Animals; Humans; Intestine, Small; Organoids; Rats; Short Bowel Syndrome; Tissue Engineering
PubMed: 15492555
DOI: 10.1097/01.sla.0000143247.86028.c2 -
International Journal of Radiation... Jan 1994The small intestine with its high cell proliferation, well-accepted hierarchy, high radiation susceptibility and low cancer incidence is a useful model for studying the... (Review)
Review
The small intestine with its high cell proliferation, well-accepted hierarchy, high radiation susceptibility and low cancer incidence is a useful model for studying the controls of cell replacement. Apoptosis, which represents part of the overall homeostatic process, occurs spontaneously at the stem cell position in the crypts, and very small doses of radiation elevate the levels of apoptosis rapidly in this region. Other cytotoxic agents also target cells in this region including several mutagenic chemicals. Yet other drugs target cells at higher positions in the crypt indicating that all crypt cells possess the programme for apoptosis, but this is normally suppressed in many of the cells. In contrast, high doses of radiation are required to reproductively sterilize the crypts and, using clonal regeneration techniques, the number of clonogenic cells is dependent on the levels of damage induced (dose), i.e. the more injury that is induced the greater number of cells that are recruited into the clonogenic compartment. All doses of radiation trigger rapid changes in proliferation in the stem cell region which suggests that the detection of the induced cell death (even small levels, such as one apoptotic cell per crypt) is efficient and has rapid consequences. p53 may be involved in this damage recognition and apoptosis initiation. The studies to date suggest that apoptosis plays an important role in this tissue in terms of its homeostasis and its protection against carcinogenesis by removal of potentially carcinogenic damaged cells.
Topics: Animals; Apoptosis; Intestine, Small; Mice
PubMed: 7905913
DOI: 10.1080/09553009414550101 -
Journal of Pediatric Gastroenterology... Feb 1991
Topics: Animals; Cell Differentiation; Intestinal Mucosa; Intestine, Small
PubMed: 2051263
DOI: 10.1097/00005176-199102000-00001